Healthcare Provider Details

I. General information

NPI: 1164638755
Provider Name (Legal Business Name): WEIGUO ZHU M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

27451 RAINBOW RIDGE RD
PALOS VERDES PENINSULA CA
90274-4026
US

V. Phone/Fax

Practice location:
  • Phone: 310-951-1323
  • Fax:
Mailing address:
  • Phone: 310-951-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA90992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: